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Profs. Anuja Premawardhena, David Weatherall, and David Nathan are gratefully acknowledged for their help in arranging this experience. Vijay G. Sankaran* ?, * Children's Hospital Boston, Boston, Massachusetts, ? Harvard Medical School, Boston, Massachusetts. ""The neutrophil/lymphocyte (N/L) ratio at diagnosis has been http://www.selleck.cn/products/Erlotinib-Hydrochloride.html shown to be a prognostic factor for survival in solid tumors. The N/L ratio at diagnosis as a prognostic factor for non-Hodgkin lymphoma (NHL) has not been studied. Thus, we studied N/L ratio at diagnosis as a prognostic factor for patients with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP. From 2000 until 2007, 255 consecutive DLBCL patients, originally diagnosed, treated with R-CHOP, and followed at Mayo Clinic, Rochester, were included in this study. With a median follow-up of 4.0 years (range: 0.3�C9.0 years), patients with an N/L ratio http://www.selleckchem.com/products/MK-2206.html independent prognostic factor for OS and PFS. This study suggests that baseline N/L ratio at diagnosis is a simple, inexpensive, standardized prognostic factor to assess clinical outcomes in DLBCL patients treated with R-CHOP. Absolute lymphocyte count (ALC), as a surrogate marker of host immunity, has been reported to a prognostic factor for survival in patients with diffuse large B-cell lymphoma (DLBCL) at diagnosis [1�C4], or after first http://www.selleckchem.com/products/ABT-263.html relapse [5]. In solid tumor, baseline neutrophil count, as a surrogate marker of inflammation, has been associated with survival [6�C8]. Furthermore, the neutrophil/lymphocyte (N/L) ratio at diagnosis in solid tumors has been reported to be a prognostic factor for clinical outcomes [9�C13]. The rationale for the N/L ratio is to compare the inflammatory response (i.e., neutrophils) produced by cancer to the host immunity (i.e., lymphocytes). Thus we set out to investigate if N/L ratio at diagnosis is a predictor of survival in DLBCL patients treated with rituximab, cyclophosphamide, adriamycin, vincristine, and prednisone (R-CHOP). The median age at the time of diagnosis for this cohort of 255 DLBCL patients was 64 years (range: 20�C92). The distribution of additional baseline characteristics for the cohort are presented at on line Supporting Information Table I. The median follow-up on living patients (N = 170) in this cohort was 59.1 months (range: 13.9�C107.8). Fifty-eight patients died due to lymphoma recurrence and 27 patients due to non-lymphoma related causes.